NPS: Desvenlafaxine (Pristiq) not superior to venlafaxine for major depressive disorder

The National Prescribing Service Limited (Australia) made an independent evaluation on the role of desvenlafaxine (Pristiq) for the treatment of major depressive disorder.


    • Desvenlafaxine is the active metabolite of venlafaxine.
    • There is no evidence that desvenlafaxine is more effective, safer or better tolerated than venlafaxine or other antidepressants.
    • Doses above 50 mg/day are unlikely to provide further clinical benefit and are associated with a higher incidence of adverse effects.
    • Common adverse effects include nausea, headache, dizziness, dry mouth and diarrhoea.
    • Desvenlafaxine should not be used in children and adolescents.
    • Reduce the dose slowly to avoid discontinuation symptoms.

In an article published in Annals of Pharmacotherapy.  Desvenlafaxine: Another "Me Too" Drug?, the authors conclude:

“With the overall similarity between these 2 drugs and the potential lack of cost savings, the need for desvenlafaxine and its ultimate utility in treating major depressive disorder appears to be insignificant.”

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